- The aftermath of sexual abuse in children and adolescents and the uphill swim towards healing
For children and adolescents who are victims of sexual abuse, or abuse of any form for that matter, the aftermath is yet another challenge. Overcoming the trauma, the psychological impact of what they have experienced, and figuring out life after abuse is incredibly difficult. This is often compounded by the lack of access to support and resources, negative reactions from family members and society, and prolonged self-stigmatisation.
To understand the process of healing from sexual abuse trauma for children and adolescents, Brunch spoke to National Institute of Mental Health Sri Lanka (NIMH) Consultant Psychiatrist Dr. Mahesan Ganesan MD (Psych), and sexual abuse survivor and freelance beautician Dominique Croos Sedra.
The psychological implications of sexual abuse in children and adolescents, the current system, and the healing process
Sharing his thoughts with us, Dr. Ganesan stated that the term “abuse” in general refers to a very broad group of incidents, ranging from somebody exposing the child or adolescent to inappropriate material, to rape and sexual abuse. According to Dr. Ganesan, the impact is compounded by how prolonged the abuse is. Both the support system available and the duration of the abuse are critical in the healing process, according to him. He further said that if the abuse has happened at the hands of a family member, usually, the impact is much more severe. “95% of the time the abuse happens from a known person such as a family member, teacher, family friend, or neighbour, where the child is either feeling ashamed to disclose what happened, or simply is unable to comprehend what has transpired,” he stated.
Describing the short-term impacts, he mentioned that self-isolation, shame, and crying spells are among the most common signs observed in abuse victims. However, he also stressed that in the long term, depression, anxiety, post-traumatic stress disorder, and in some cases precocious behaviour (stemming from a belief that sexuality is the way in which they can obtain attention), along with an inability to form strong relationships, could be prevalent.
Elaborating on the treatment that is required after the abuse, Dr. Ganesan shared that immediately after the abuse, the presence of trusting and supportive relationships and therapeutic help, along with minimal disruption to the child’s life is vital, and that if a child is able to get back to their normal lifestyle such as school activities, the normalisation process will be easier. “If the child or adolescent shows signs of distress, post-traumatic stress, or sleep interruptions, we may need some medications to help ease this in the child,” he shared, while mentioning that a psychologist, psychiatrist, therapist, child protection officer, and even the justice system have a role to play in the recovery of a sexual abuse victim.
Delving a little deeper into social perspective, Dr. Ganesan shared that the current justice system may re-traumatise the victim. Most of the time, if a victim shares the experience with a teacher or a friend, the entire community comes to know of it because confidentiality is not protected. In addition, if the abuse is reported to the authorities, repeated interrogation by different parties such as health professionals and law enforcement authorities can traumatise a victim even more. “Even though the best interests of the child may be mentioned on paper, this is not enforced in real life. Depending on the age of the child, they should ideally have a say in what happens to them, but that is not the case in reality,” he further stated.
Dr. Ganesan also stated that stigmatising statements such as “why was it only you who was abused?” or, “did you not know you should not talk to strangers?” can contribute to feelings of self-blame and shame within the victim. He further shared that such statements can spring up because of the fact that the family members themselves are also traumatised from what has happened when they hear about it, which then results in denial. This kind of mindset, along with the fact that reporting is not mandatory in Sri Lanka at the moment, according to Dr. Ganesan, adds to the immense pile of issues that the victim will face, along with why only a very small fraction of abuse cases are reported.
“Something that I have seen is that when adults come in to get treatment for depression or anxiety or other such issues in adult life, we start talking to them and we realise that in their childhood they have been subjected to abuse which they have not told anyone about yet,” Dr. Ganesan added, while also sharing his opinion on the standards required for a professional to treat a victim of abuse. “For the most part, probation officers in Sri Lanka do not have the right qualifications to work with a child. They most often have a degree in an unrelated field with a short course they have completed with regards to abuse victims. In fact, the Probation Department itself does not have a psychiatrist or psychologist to even train their staff,” he shared, shedding light onto the grave situation in Sri Lanka with regards to how sexual abuse victims are tended to.
The real-life experiences of sexual abuse and the road to healing
Freelance beautician Dominique Croos Sedra, a survivor of sexual abuse as a child and adolescent, spoke to Brunch, sharing her experiences and what her journey of healing has been like.
“I was sexually abused for about seven or eight years by three different men. It started when I was six and continued for two years with one man, who also was a father and a close family friend, which led my family to believe that he is trustworthy,'' she shared, while adding that the abuse started again when she was eight years, continuing for about two-and-a-half years, with a different individual this time, who used to drop her and her younger sister at school. She went on to say that her sister was never targeted by this person and that both she and her sister would fall asleep in the vehicle, and she would often wake up to him sexually abusing her. She further added that sweets were offered to her as a method of persuading her to stay silent about the abuse.
Her third encounter with sexual abuse also consisted of emotional and other physical abuse which, Dominique said, is the worst experience that she has had. She shared that this encounter was with her cousin, who she found to be very intimidating and who had also threatened her in order to keep her quiet.
When asked if she had access to support and resources and how she felt about sharing the experience with her parents, Dominique shared that she only spoke of the abuse once she was about 15 years old, which was much later. “I just felt ashamed and felt the need to keep all this hush-hush. My younger sister has also been through sexual abuse, although not by the same men. However, she used to be very outspoken about it and whenever she spoke out about what was happening, my parents would get flustered, they would cry and panic, and that really made it difficult for me to talk to them,” she stated. She also added that in addition to the reactions of her family members, she also feels that sometimes in the immediate aftermath of abuse, a victim can feel like they just want somebody to listen to them, believe them, and understand them, and that they would want the whole experience to “disappear” rather than have such a strong and negative reaction from those around you.
“I feel like something that doesn’t get discussed much about, but needs to be, is that even when you are being abused, your body may react positively towards what is happening. I remember feeling terrible about what was happening, but also knowing that my body is reacting positively towards it. That is just biology, and people should know that, that does not invalidate what has happened and that the abuse victim is not to be blamed for it,” Dominique shared. Explaining further, she stated that as a child, while she was terribly uncomfortable and did not in any way enjoy the abuse, the act of somebody touching her body also evokes a positive biological reaction which is out of her control – something which she struggled with for a long time.
Talking about the latent effects of her abusive experiences, she shared that she would always feel a sense of anxiety, fear, and panic if she was so much as in the same room with about three men on her own. “I’m sorry, this is a trigger warning, but my mind kept thinking, what if they pinned me to a corner of the room now and raped me?” she said. In addition, she also found it hard to invest in physical intimacy with complete comfort, as she would, for the most part, feel objectified and wonder if people wanted to use her as a sexual object. She also added that while she has healed now to a great extent, she also suffered from post-traumatic stress disorder, where she was unable to breathe and would see “stars” during an episode.
Discussing her journey of healing, Dominique suggested that anybody who can and wants to, should seek therapeutic assistance. However, she said that for her, she made up her mind to heal on her own and that the biggest milestone in her journey of healing was forgiving herself and understanding that what happened to her was not her fault.
How can we best help victims of any form of abuse?
Being abused in any manner is a traumatic experience for any individual regardless of their age, gender, race, or other social identity factor. The support that needs to be extended towards those who have gone through abuse, needs to begin in our homes, schools, and in our localities. The removal of stigma, negative reactions, and over-emphasising what has occurred is essential in providing a feeling of safety and comfort for these individuals.
While the prevailing systems, according to professionals, need to see reforms urgently in their approach to providing a safe haven for abuse victims, our mindset in itself is what needs the most profound change. Education systems need to be current and comprehensive about sexuality. Staying vigilant, even with those you may think are harmless, is of paramount importance. But more importantly, understanding that sexual abuse, or any form of abuse, tends to leave a lasting impact on its survivors and that extending respectful compassion towards them is what will help them recover and rediscover themselves in the long run, is a fact we should all honour.